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Region Hovedstaden - en del af Københavns Universitetshospital
E-pub ahead of print

Soluble ST2 in plasma is associated with post-procedural no-or-slow-reflow after PCI in ST-elevation myocardial infarction

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


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BACKGROUND: The no-or-slow-reflow phenomenon after primary percutaneous coronary intervention (pPCI) is associated with more extensive myocardial injury in ST-elevation myocardial infarction (STEMI) patients. Soluble suppression of tumorigenicity 2 (sST2) is released in acute myocardial response to injury, and an increase in plasma level in the initial phase of STEMI is associated with increased mortality and risk of heart failure.We have therefore explored the association of pre-intervention plasma sST2 with the post-procedural no-or-slow-reflow phenomenon in patients with STEMI.

METHOD: We included consecutive patients with verified STEMI from two tertiary heart centers. Blood samples were collected at admission before angiography. Post-procedural coronary flow was assessed according to thrombolysis in myocardial infarction (TIMI) classification for STEMI. Patients were divided into two groups: Post-procedural TIMI 0- 2 as no-or-slow-reflow and TIMI 3 as normal reflow. The association between sST2 and TIMI flow was explored using multiple logistic regression.

RESULTS: 1,607 patients with available TIMI flow classification were included in the analysis. Normal reflow was seen in 1,520 (94.6%) while 87 (5.4%) had no-or-slow-reflow. No-or-slow-reflow patients had higher all-cause 30-day mortality (10 (11%) vs. 65 (4.3%), p = 0.006). Preprocedural sST2 was higher in the no-or-slow-flow group (47 ng/mL (IQR 33 - 83) vs. 39 ng/mL (IQR 29-55, p < 0.001) and was independently associated with post-procedural no-or-slow-flow (two-fold sST2 increase: OR 1.44 (1.15-1.78, p = 0.0012)).

CONCLUSION: In patients with STEMI, the sST2 level at admission before coronary angiography is independently associated with the post-procedural no-or-slow-reflow phenomenon.

TidsskriftEuropean heart journal. Acute cardiovascular care
StatusE-pub ahead of print - 10 nov. 2022

Bibliografisk note

© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail:

ID: 85792815